Hadrian Health Centre

Updated 25 July 2016

Park Road Medical Practice is registered with the Care Quality Commission to provide primary care services. It is located in the town of Wallsend in North Tyneside.

The practice provides services to around 4,900 patients from one location: 93 Park Road, Wallsend, Tyne and Wear, NE28 7LP. We visited this address as part of the inspection. The practice has four GP partners (three female and one male), two salaried GPs (both female), two practice nurses (both female), a healthcare assistant, a practice manager, and seven staff who carry out reception and administrative duties.

The practice is a training practice and two of the GPs are accredited GP trainers. At the time of the inspection there were two trainee GPs working at the practice.

The practice is part of North Tyneside clinical commissioning group (CCG). The practice population age profile is in line with national averages. Information taken from Public Health England placed the area in which the practice is located in the fifth more deprived decile. In general, people living in more deprived areas tend to have greater need for health services.

The practice is located in a converted two storey building. Patient facilities are on the ground and first floors. There is no dedicated patient car park at the site however; there is parking in the streets surrounding the surgery. There is a disabled WC and the site had level access; however, there is no lift to the first floor. Arrangements have been made to provide consultation rooms on the ground floor which are suitable for patients with mobility problems.

Opening hours are between 8.30am and 6pm Monday to Friday, with an evening surgery every Tuesday between 6.30pm and 9pm. Patients can book appointments in person, on-line, by telephone or by using an ‘App’ on their mobile phone. Appointments were available at the following times:

• Monday - 8.30am to 11.30am; then from 2.30pm to 5.40pm
• Tuesday – 8.30am to 11.30am; from 2.30pm to 5.40pm; then from 6.30pm to 9pm
• Wednesday – 8.30am to 11.30am; then from 2.30pm to 5.40pm
• Thursday – 8.30am to 11.30am; then from 2pm to 5.40pm
• Friday – 8.30am to 11.30am; then from 2.30pm to 5.40pm

A duty doctor is available each morning from 8am and every afternoon until 6.30pm.

The practice provides services to patients of all ages based on a Personal Medical Services (PMS) contract with NHS England.

The service for patients requiring urgent medical attention out of hours is provided by the NHS 111 service and Northern Doctors Urgent Care Limited.

Updated 25 July 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Park Road Medical Practice on 19 May 2016. Overall the practice is rated as outstanding.

Our key findings were as follows:

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance.
• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand.
• Patients said they were able to get an appointment with a GP when they needed one, with urgent appointments available the same day.
• The practice was integrated in the local community; managers were aware of the housing problems faced by some people and provided appropriate support.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure in place and staff felt supported by management. The practice proactively sought feedback from staff and patients, which they acted on.
• Staff worked well together as a team and there were processes in place to manage staff training effectively.

We saw several areas of outstanding practice including:

• Following a suggestion made by the practice’s patient participation group, the practice developed and implemented a ‘discharge and handover’ policy. Every patient who had been discharged from hospital was contacted to ask how they were and if they needed any support or help with medication.
• There was a system in place to invite patients in for a teenage health check once they reached their 16th birthday; in the past year 21 patients had taken up the offer. A practice leaflet had been produced for patients between the ages of 13 and 19; this provided contact details and pictures of all of the GPs and information about the dedicated young people’s services offered by the practice. The practice had carried out a survey of eight young people to ascertain whether they found the leaflet relevant and easy to understand, all patients responded and all reported the leaflet was useful.
• A ‘new baby pack’ had been developed by the practice; this was sent out to all new parents and provided information about baby clinics and how to seek medical advice for young families. Each day, a number of ‘sick children’ appointments were embargoed for booking babies or young children with a GP. Many of these appointments were held until mid-afternoon when children had finished school for the day.

The area where the provider should make improvements is:

• Take steps to ensure the infection control action plan is completed; with regard to replacing the carpet in one of the nurse’s clinical rooms with appropriate flooring.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 25 July 2016

The practice is rated as outstanding for the care of patients with long-term conditions, as the practice is rated as outstanding overall.

• Nursing staff had lead roles in chronic disease management and patients at risk of admission to hospital were identified as a priority.
• Longer appointments and home visits were available when needed. The practice’s electronic system was used to flag when patients were due for review. This helped to ensure the staff with responsibility for inviting people in for review managed this effectively.
• Patients had regular reviews to check with health and medicines needs were being met.
• For those people with the most complex needs, GPs worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 25 July 2016

The practice is rated as outstanding for the care of families, children and young people.

• The practice had identified the needs of families, children and young people, and put plans in place to meet them.
• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances. Immunisation rates were relatively high for all standard childhood immunisations.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• The practice’s uptake for the cervical screening programme was 83.1%, which was in line with the local average of 83.1% but above the national average of 81.8%.
• Pregnant women were able to access an antenatal clinic provided by healthcare staff attached to the practice.
• A ‘new baby pack’ had been developed by the practice; this was sent out to all new parents and provided information about baby clinics and how to seek medical advice for young families. Each day, a number of ‘sick children’ appointments were embargoed for booking babies or young children with a GP.
• The practice was in the process of completing the ‘You’re Welcome’ project (this had the aim of making health services young people friendly). There was a system in place to invite patients in for a teenage health check once they reached their 16th birthday.

Updated 25 July 2016

The practice is rated as outstanding for the care of older people, as the practice is rated as outstanding overall.

• The practice offered proactive, personalised care to meet the needs of the older people in its population. For example, all patients over the age of 75 had a named GP. Patients at high risk of hospital admission and those in vulnerable circumstances had care plans.
• The practice was responsive to the needs of older people and offered home visits and urgent appointments for those with enhanced needs. Doctors carried out a weekly ward round and had regular phone contact with staff at a local nursing home.
• A palliative care register was maintained and the practice offered immunisations for pneumonia and shingles to older people.

Updated 25 July 2016

The practice is rated as outstanding for the care of working age people (including those recently retired and students), as the practice is rated as outstanding overall.

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible and flexible. Extended hours surgeries were offered on Tuesday evenings with doctors and nurses for working patients who could not attend during normal opening hours.

• The practice offered a full range of health promotion and screening which reflected the needs for this age group. Patients could order repeat prescriptions and book appointments on-line. Appointments could also be booked via a mobile device ‘App’.

• Additional services were provided such as health checks for the over 40s and travel vaccinations.

Updated 25 July 2016

The practice is rated as outstanding for the care of people experiencing poor mental health (including people with dementia), as the practice is rated as outstanding overall.

• The practice worked closely with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. Care plans were in place for patients with dementia.
• Patients experiencing poor mental health were sign posted to various support groups and third sector organisations.
• The practice kept a register of patients with mental health needs which was used to ensure they received relevant checks and tests.
• The practice was the first in the North Tyneside area to register with the Dementia Action Alliance and staff within the practice had been trained as ‘dementia friends’.

Updated 25 July 2016

The practice is rated as outstanding for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances, including those with a learning disability.
• Patients with learning disabilities were invited to attend the practice for annual health checks and were offered longer appointments, if required.
• The practice had effective working relationships with multi-disciplinary teams in the case management of vulnerable people.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in and out of hours.
• Good arrangements were in place to support patients who were carers. The practice had systems in place for identifying carers and ensuring that they were offered a health check and referred for a carer’s assessment.
• The practice was part of the local authority’s ‘safe and healthy homes’ pilot. This provided advice and guidance to help patients to solve health-related housing issues and improve their physical and mental health through referrals to relevant services and organisations.